MEDICARE: CESAR D TRIVINO MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	L5592	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0078KQ	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366629024
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CESAR D TRIVINO MD PA

Provider Business Mailing Address
First Line	:	304 LOMA LINDA LN STE 100
Second Line	:
City	:	BORGER
State	:	TX
Zip	:	79007-8500
Country	:	US
Telephone Number	:	806-275-9064
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 S MCGEE ST
Second Line	:	ANESTHESIA SUITE
City	:	BORGER
State	:	TX
Zip	:	79007-4022
Country	:	US
Telephone Number	:	806-275-9064
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CESAR DAVID TRIVINO
Credential	:	MD
Telephone Number	:	806-275-9064

Provider Enumeration Date	:	01/24/2008
Last Update Date	:	10/07/2009

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Directions to “CESAR D TRIVINO MD PA ” Practice Location

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